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Biomedical subjects

M A Lennon

Publications and source records attributed to M A Lennon.

At least 19 recordsLinked to original sources
PubMed2006

A randomised controlled trial of the effect of outreach placement on treatment planning by dental students.

UNLABELLED: Undergraduate dental students' curricula are being supplemented with primary care placements. OBJECTIVE: To compare the effect of outreach placement and traditional hospital-based training alone on students' treatment planning ability. DESIGN: Randomised controlled trial.Setting Four existing primary care placements in England during 2004. SUBJECTS AND METHODS: At follow-up the fourth-year students took a history from a standard 'patient' then recorded a treatment plan. Interview skill was scored. The history and plan were assessed by clinicians blind to the intervention. INTERVENTION: Five-week block outreach placements for 25 of 49 students. MAIN OUTCOME MEASURES: Interviewing skill, quality of dental and social histories, the appropriateness of planned treatments and the consideration of wider issues. RESULTS: The two groups were similar in the scores for interviewing and taking a dental history. The outreach group scored higher for capturing a social history (outreach mean 4.4, SD = 2.1, n = 22 and hospital 2.8, SD = 1.9, n = 23; p = 0.01) and for developing an appropriate treatment plan (5.6 [SD = 2.1] and 3.9 [SD = 2.3]; p = 0.01). There were no differences in scores relating to the wider issues. CONCLUSION: Dental outreach training was significantly more effective than traditional training alone in improving students' ability to capture relevant points of social history from a patient and to consider them when planning treatment.

Clinical Clerkship↗
PubMed2006

Perspectives of staff on student outreach placements.

OBJECTIVE: To explore the perspectives of placement staff on outreach training. INTERVENTION: Block clinical placements in primary care settings for dental undergraduates and hygiene and therapy students. METHOD: After completion of the placements, 32 participating staff across nine primary care locations took part in qualitative interviews and focus groups. The staff provided data on placement organisation, the students' development and their supervision, and any effects on themselves as hosts. RESULTS: The major themes included the learning environment, supervision and communication. The staff saw benefits to students in working in a smaller primary care clinic with nursing support and immediately available supervision by a dental generalist. Other benefits included increased confidence, broader clinical experience and applying theoretical learning to new communities. Effective communication and adequate resourcing were critical success factors. There was some disruption of clinics' normal working, but many unanticipated benefits. Staff supported the outreach placements in primary care settings to enhance students' dental education. CONCLUSIONS: These findings provide a planning and evaluation framework for dental educators involved in outreach.

Attitude of Health Personnel↗
PubMed2006

Student perspectives on their recent dental outreach placement experiences.

BACKGROUND: Dental schools are developing new curricula, with outreach placements enhancing the hospital-based training. OBJECTIVES: To assess the students' experience of outreach as one component of determining the value and feasibility of outreach placements. INTERVENTION: Six-week block placements for 10 undergraduates and 3 weeks for 11 hygiene and hygiene and therapy students in existing primary care clinics, in areas of need, to work supervised by local dentists. METHODS: Semi-structured interviews with 20 students by staff independent of the course team. Interviews were audio-recorded, transcribed and content analysed before being verified by a second observer. Findings were triangulated against a peer-run focus group and students' clinical records. RESULTS: Students were very positive about their experience and the potential role of outreach training in dental education. They described: gaining greater experience of new types of patients and their communities; learning from broader clinical experience, alternative approaches and practicing or observing dentistry in different settings; the benefits of team working; and, acquiring a more holistic and pragmatic view of health care. Many students reported gaining greater confidence, wider awareness of potential careers in dentistry and a greater sense of realism in their experience. Some reflected on their own training needs. Students also discussed the importance of preparation for the placements and the merits of different styles of supervision. CONCLUSION: Dental outreach training can provide students with valuable learning experience in a range of areas. It requires careful management to ensure those experiences match individuals' needs and the programme's purposes.

Attitude of Health Personnel↗
PubMed2004

The personal dental service as a setting for an undergraduate clinical programme.

OBJECTIVE: To investigate the feasibility and benefits of placing dental undergraduates into a general dental practice setting for part of their clinical programme. SETTING: Two six-surgery general dental practices in the North West of England operating within the personal dental service of the NHS. METHOD: Six volunteer final year students worked within the practices for one-day-per week for 11 weeks. Evaluation included patients', practitioners' and students' views obtained from questionnaires and/or interviews and an analysis of students' clinical records. RESULTS: The students saw a large positive impact from: working alongside a dental nurse; developing their clinical skills; working in a busy practice environment; and developing interpersonal skills. Patients were very positive with 98% (44/45) being complimentary about the treatment they received, and commenting that they would be willing to participate in future student training programmes. The practice principals would also welcome continuation of the programme. CONCLUSION: The programme was both feasible and educationally beneficial. The financial implications need further research.

Attitude of Health Personnel↗
PubMed2003

Recording and understanding social histories by dental undergraduates in a community-based clinical programme.

Although social inequalities are known to account for large differences in dental health, attitudes to dental attendance and the type of treatment received by the patient, the taking of a patient's social history receives little emphasis in dental undergraduate teaching. Social history is defined as recording the social and family circumstances of the patient. An exercise undertaken by undergraduate dental students on clinical placements in the Community Dental Service (CDS) is described. Students write a profile of the community in which the clinic is situated, write case histories for two of their patients and then highlight issues illustrated by the case histories with reference to information on the wider community and published literature on inequalities in health and barriers to care. Students completing the exercise in April 2000 and their tutors were given additional information, including a checklist to help in the completion of the social histories of the two patients. A comparison with the reports submitted in the previous year showed that this significantly improved the recording and understanding of social history. This exercise provides a means whereby dental public health issues can be taught to undergraduates whilst maintaining relevance to the clinical setting.

Clinical Clerkship↗
PubMed2003

The use of school milk as a vehicle for fluoride in Knowsley, UK; an evaluation of effectiveness.

OBJECTIVE: To compare caries in children initially aged 3 to 5 years who had participated for four years in a fluoridated school milk programme with a group of children in a similar community drinking non-fluoridated milk. STUDY DESIGN: A four-year longitudinal study measuring caries experience and caries increment in primary molars and caries experience in permanent molars and incisors. METHOD: 478 children in Knowsley (test group) and 396 in Skelmersdale (comparison group) were examined for caries (dmft/dfs) at baseline in 1997. Of these, 318 in Knowsley and 233 in Skelmersdale were re-examined at follow-up (dmft/dfs and DMFT/DFS) in 2001. RESULTS: The mean ages at baseline of the children from the test and comparison groups were 4.7 and 4.8 years respectively. The baseline dmft/dfs was 1.73/2.51 in the test group and 1.29/2.15 in the comparison group. The 4-year dmft/dfs mean increments were 2.28/4.49 and 1.96/4.12 in test and comparison groups respectively. The DMFT/DFS at age 7-9 years in the test and comparison groups were 0.40/0.45 and 0.40/0.55 respectively. CONCLUSION: The fluoridated school milk scheme, as configured in Knowsley. Merseyside, did not reduce caries within the primary dentition and, at best, had a small clinical impact on the permanent dentition up to 8 years of age.

Analysis of Variance↗
PubMed2002

Reducing patients' state anxiety in general dental practice: a randomized controlled trial.

Anxiety assessment by questionnaire provides information for the dentist and may also confer a psychological benefit on patients. This study tested the hypothesis that informing dentists about patients' dental anxiety prior to commencement of treatment reduces patients' state anxiety. A randomized controlled trial was conducted involving eight General Dental Practitioners in North Wales. Participants included patients attending their first session of dental treatment, and accumulating a score of 19 or above, or scoring 5 on any one question, of the Modified Dental Anxiety Scale (MDAS). Patients (n = 119) completed Spielberger's state anxiety inventory (STAI-S) pre- and post-treatment and were randomly allocated to intervention (dentist informed of MDAS score) and control (dentist not informed) groups. Intervention patients showed greater reduction in mean change STAI-S scores (F[1,119] = 8.74, P < 0.0001). Providing the dentist with information of the high level of a patient's dental anxiety prior to treatment, and involving the patient in this, reduced the patient's state anxiety.

Adult↗
PubMed2001

York review.

Explore the source record for details and available documents.

Fluoridation↗
PubMed2001

The use of dental anxiety questionnaires: a survey of a group of UK dental practitioners.

AIM: To determine the frequency of use of dental anxiety assessment questionnaires and factors associated with their use in a group of UK dental practitioners. METHOD: A postal questionnaire to all 328 dentists whose names appear in the British Society for Behavioural Sciences in Dentistry Directory. Information collected for each practitioner included gender, year of qualification, type of practice in which anxious dental patients were treated, treatment used to manage anxious dental patients, type and frequency of use of dental anxiety assessment indices. RESULTS: Questionnaires were returned from 275 (84%) practitioners. 269 were analyzed. Only 54 practitioners (20%) used adult dental anxiety assessment questionnaires and only 46 (17%) used child dental anxiety assessment questionnaires. Male practitioners were more likely to report questionnaire use in comparison with females (P< 0.05), when treating dentally anxious adults (26% v 14%). In addition, practitioners providing intravenous sedation were more likely to use an adult dental anxiety questionnaire (P < 0.04) than those who did not use intravenous sedation (29% v 15%). The type of treatment provided had a significant association with the use of child dental anxiety. Those providing general anaesthesia (P = 0.03) and hypnosis (P = 0.01) for dentally anxious children were more inclined to use a questionnaire. CONCLUSION: The use of pre-treatment dental anxiety assessment questionnaires was low in this group of dentists. Male practitioners and those providing intravenous sedation, general anaesthesia or hypnosis seem more likely to use dental anxiety assessment questionnaires.

Adult↗
PubMed2001

Factors affecting dental attendance following treatment for dental anxiety in primary dental care.

AIM: To explore factors affecting patients' dental attendance behaviour following referral from a dental anxiety clinic to a general dental practitioner. DESIGN: A four-year follow up of patients who completed a course of treatment for dental anxiety by conducting semi-structured interviews, face-to-face or by telephone, with confirmation of dental attendance from the dental records. SUBJECTS: Forty-one patients who had completed a course of treatment for dental anxiety, in a specially designed community clinic. Mean time since last dental visit before treatment was 7.8 years (range 0.5-29). RESULTS: Twenty-three patients were successfully followed up and 11 (47%) were receiving regular asymptomatic dental care. The dental anxiety scores of those who subsequently became asymptomatic attenders were significantly lower at follow-up than the patients who became symptomatic attenders (P = 0.01). Effective dentist-patient communication was a common theme of the interviews. CONCLUSIONS: At four-year follow-up, dental anxiety was substantially lower in those who subsequently became asymptomatic attenders than those who became symptomatic attenders. A positive dentist-patient relationship had developed with the asymptomatic attenders.

Adult↗
PubMed2001

School milk as a vehicle for fluoride in the United Kingdom. An interim report.

OBJECTIVE: To consider the feasibility of using school milk as a vehicle to deliver fluoride to children, suffering from high rates of dental disease, in socially deprived districts. METHOD: The legal aspects of adding fluoride to milk and availability of milk subsidies were updated. The organisational requirements of using school milk as a vehicle for fluoride were investigated and the consultation process established. The uptake of fluoridated milk was monitored and the fluoridated milk was subjected to rigorous quality control. The costs involved in running a scheme were calculated. OUTCOME: Fluoridated milk can now be called milk with added fluoride and to date the product has attracted subsidies from the European Economic Community and from the Welfare Foods Section in the Department of Health. The demonstration scheme in St. Helens, Merseyside, generated interest from neighbouring health authorities leading to the subsequent expansion of the programme. By working with the dairy, recommendations to improve the quality of school milk have been developed. The main organisations involved in running school based milk fluoridation schemes have been encouraged by the low costs involved. CONCLUSION: The UK programme has demonstrated that it is feasible to use school milk as a vehicle to deliver fluoride on a community basis. Attention must be given to improving the quality and particularly the temperature control of school milk.

Animals↗
PubMed2000

How much do the general public want to be involved in decisions on implementing water fluoridation?

OBJECTIVE: Test general public view about how much they wish to be involved in water fluoridation implementation decisions. DESIGN: Qualitative research using focus group discussions led by an experienced moderator. SETTING: Among the general public living in three non-fluoridated areas in England. SUBJECTS: Members of the public more than 20 years of age and by social class. RESULTS: General public wish to be informed of water fluoridation plans but do not see themselves as being the appropriate implementation arbiters. CONCLUSIONS: In the public's eyes, it would be inappropriate and unwelcome to delegate to them the decision about whether to fluoridate the public water supply.

Adult↗
PubMed2000

Urinary fluoride excretion in children drinking fluoridated school milk.

OBJECTIVE: To determine fluoride excretion under various conditions of fluoride intake and to estimate the fractional urinary excretion of fluoride in individual children participating in a school milk fluoridation scheme. DESIGN: In the first part of the study, individual urine samples were collected from each of eight 4 to 5-year-old children for a continuous period of 55 h. For each child (n = 8) and for each day (n = 3) the maximum urinary fluoride concentration (p.p.m.F), the maximum fluoride excretion rate (microgram F/h) and the total daily fluoride excretion (mg) were calculated. The second part of the study was carried out to determine the 24 h fractional percentage of fluoride excreted following administration of a known dose of fluoride in the absence of other sources. RESULTS: Under usual conditions of fluoride intake (i.e. milk containing 0.5 mg fluoride, customary diet and toothbrushing with fluoride toothpaste) the children's daily fluoride excretion was 0.33 mg. The fractional urinary fluoride excretion of a 0.5-mg fluoride tablet was 30%. CONCLUSIONS: It is concluded that the children's mean 24 h fluoride excretion was somewhere between that reported in low fluoride conditions and that reported in optimally fluoridated areas. The fractional urinary fluoride excretion was found to be in agreement with the findings of other workers.

Animals↗
PubMed1999

The effect of water fluoridation and social inequalities on dental caries in 5-year-old children.

BACKGROUND: Many studies have shown that water fluoridation dramatically reduces dental caries, but the effect that water fluoridation has upon reducing dental health inequalities is less clear. The aim of this study is to describe the effect that water fluoridation has upon the association between material deprivation and dental caries experience in 5-year-old children. METHODS: It is an ecological descriptive study of dental caries experience using previously obtained data from the British Association for the Study of Community Dentistry's biennial surveys of 5-year-old children. This study examined the following data from seven fluoridated districts and seven comparable non-fluoridated districts in England: 1) dental caries experience using the dmft (decayed, missing, filled teeth) index; 2) the Townsend Deprivation Index of the electoral ward in which the child lived; 3) whether fluoride was present at an optimal concentration in the drinking water or not. RESULTS: A statistically significant interaction was observed between material deprivation (measured by the Townsend Deprivation Index) and water fluoridation (P < 0.001). This means that the social class gradient between material deprivation and dental caries experience is much flatter in fluoridated areas. CONCLUSION: Water fluoridation reduces dental caries experience more in materially deprived wards than in affluent wards and the introduction of water fluoridation would substantially reduce inequalities in dental health.

Child, Preschool↗